Ominous triad triggered by high-dose glucocorticosteroid therapy.

Bär, Sarah; Daudel, Fritz; Züger, Thomas (2017). Ominous triad triggered by high-dose glucocorticosteroid therapy. BMJ case reports, 2017 BMJ Publishing Group 10.1136/bcr-2017-220328

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Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy. Our patient's condition was further aggravated by a circulatory shock, haemodynamic relevant bleeding from a duodenal ulcer and psychotic symptoms. In the intensive care unit, intravenous insulin infusion, fluid resuscitation, catecholamine support, electrolyte supplementation, endoscopic haemoclipping and antibiotic and antipsychotic treatment were administered, leading to a continuous improvement of the patient's health state.

Item Type:

Journal Article (Further Contribution)


04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine


600 Technology > 610 Medicine & health




BMJ Publishing Group




Andreas Melmer

Date Deposited:

27 Sep 2019 14:06

Last Modified:

27 Sep 2019 14:06

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Contraindications and precautions Diabetes Lipid disorders Metabolic disorders Pancreatitis


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